Corneal collagen cross-linking for keratoconus

Зотов, В. В.; Паштаев, Н. П.; Поздеева, Н. А.

doi:10.17116/oftalma2015131488-93

Cited by 6 publications

(3 citation statements)

References 48 publications

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“…In addition, the reduced activity of LOX [ 54 ] and levels of SFRP1 [ 66 ] are specific to the disease and highlight the molecular pathways that can be targeted for disease correction. Since collagen cross-linking is the current surgical treatment available for keratoconus [ 78 ], reduction in the natural collagen cross linkers [ 54 ] is perhaps expected. The molecular pathways leading to the elevation of collagenolytic factors [ 55 ] presents another attractive target for therapy.…”

Section: Reviewmentioning

confidence: 99%

Tear biomarkers for keratoconus

et al. 2016

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Keratoconus is a progressive corneal thinning, ectatic condition, which affects vision. Recent advances in corneal topography measurements has helped advance proper diagnosis of this condition and increased research and clinical interests in the disease etiopathogenesis. Considerable progress has been achieved in understanding the progression of the disease and tear fluid has played a major role in the progress. This review discusses the importance of tear fluid as a source of biomarker for keratoconus and how advances in technology have helped map the complexity of tears and thereby molecular readouts of the disease. Expanding knowledge of the tear proteome, lipidome and metabolome opened up new avenues to study keratoconus and to identify probable prognostic or diagnostic biomarkers for the disease. A multidimensional approach of analyzing tear fluid of patients layering on proteomics, lipidomics and metabolomics is necessary in effectively decoding keratoconus and thereby identifying targets for its treatment.

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Section: Reviewmentioning

confidence: 99%

Tear biomarkers for keratoconus

et al. 2016

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“…The efficacy of CXL with UVA radiation and riboflavin was described in patients with KC, producing a 328.9% increase in the rigidity of the cornea that would explain the positive benefits of CXL in stabilizing KC (30). This efficacy of this approach was later confirmed in clinical studies (31)(32)(33)(34)(35). Subsequently, the conventional Dresden protocol was proposed that involved the desepithelialization of the cornea by applying a riboflavin solution (0.1%) for 30 min, followed by irradiation at a wavelength of 370 nm and with a potency of 3 mW/cm 2 (36).…”

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confidence: 93%

Tear proteome profile in eyes with keratoconus after intracorneal ring segment implantation or corneal crosslinking

et al. 2022

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PurposeKeratoconus (KC) is a corneal ectasia characterized by structural changes, resulting in progressive thinning and biomechanical weakening that can lead to worsening visual acuity due to irregular astigmatism. Corneal collagen Crosslinking (CXL) and Intracorneal Ring Segment (ICRS) are widely used treatments in KC disease, but the alterations they cause in biomechanical mediators are still poorly understood. The aim of this study was to analyze the tear proteome profile before and after treatments to identify biomarkers altered by surgery.Materials and methodsAn observational, prospective, case-control pilot study was conducted, analyzing tear samples from KC patients by nano-liquid chromatography-mass spectrometry (nLC-MS/MS). Data are available via ProteomeXchange with identifier PXD035655. Patients with KC who underwent ICRS surgery (n = 4), CXL (n = 4), and healthy subjects (Ctrl, n = 4) were included in this study. Clinical parameters were measured and tear samples were collected before and 18 months after surgery. Proteins with ≥2 expression change and p-value < 0.05 between groups and times were selected to study their role in post-operative corneal changes.ResultsThese analyses led to the identification of 447 tear proteins, some of which were dysregulated in KC patients. In comparisons between the two surgical groups and Ctrls, the biological processes that were altered in KC patients at baseline were those that were dysregulated as a consequence of the disease and not of the surgical intervention. Among the biological processes seen to be altered were: immune responses, cytoskeleton components, protein synthesis and metabolic reactions. When comparing the two treatment groups (ICRS and CXL), the process related to cytoskeleton components was the most altered, probably due to corneal thinning which was more pronounced in patients undergoing CXL.ConclusionThe changes observed in tears after 18 months post-operatively could be due to the treatments performed and the pathology. Among the deregulated proteins detected, A-kinase anchor protein 13 (AKAP-13) deserves special attention for its involvement in corneal thinning, and for its strong overexpression in the tears of patients with more active KC and faster disease progression. However, it should be kept in mind that this is a pilot study conducted in a small number of patients.

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“…Conservative surgery, aimed at improving vision and/or halting the ectasia in its early stages, include corneal collagen cross-linking (CXL) [2], mini asymmetric radial keratotomy (MARK) [3], circular keratotomy (CK) [4], and implantation of intrastromal corneal ring segments (ICRS) [5]. CXL, the most recent among these, is now widely regarded as the most effective treatment for progressive keratoconus as it directly addresses the intrinsic structural weakness of the cornea by reinforcing the stroma and, thus, stopping the evolution of KC.…”

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confidence: 99%

Peripheral corneal cross-linking (P-CXL) for ultrathin corneas with severe keratoconus: a new technique

Abbondanza¹,

Felice²,

Abbondanza³

2017

Vestn. oftal'mol.

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Corneal cross-linking (CXL) is aimed at halting the progression of keratoconus and is widely considered to be the golden standard in its treatment. It is usually contraindicated, however, in patients with corneal thickness of less than 400 µm, leaving the ophthalmic surgeon no option, but to perform transepithelial CXL (epi-on), usually regarded as less effective. We report a novel approach for ultrathin corneas with severe keratoconus - peripheral corneal cross-linking (P-CXL), in which corneal epithelium is still removed but the apex of the cornea is left untouched. Hypo-osmolar riboflavin solution is used as well. P-CXL was performed on a remarkably developed stage IV keratoconus with the thinnest pachymetry of 215 µm, Kmax of 88.1 D and astigmatism of 11.2 D. Four months after P-CXL, the thinnest pachymetry increased by 42 µm, Kmax decreased by 1.4 D, and astigmatism also decreased by 3.2 D.

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Corneal collagen cross-linking for keratoconus

Cited by 6 publications

References 48 publications

Tear biomarkers for keratoconus

Tear biomarkers for keratoconus

Tear proteome profile in eyes with keratoconus after intracorneal ring segment implantation or corneal crosslinking

Peripheral corneal cross-linking (P-CXL) for ultrathin corneas with severe keratoconus: a new technique

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